Diagnosing Papillary Thyroid Cancer
Papillary thyroid cancer (PTC) is the most common type of thyroid cancer, making up about 90% of cases. It starts in the thyroid gland, which produces hormones that regulate metabolism, energy, and body temperature. PTC grows slowly and is highly treatable, with types ranging from slow growing to more aggressive forms.
To diagnose PTC, several examinations, screening tests, and procedures may be done. These include:
- Physical exam and health history: A doctor will perform a physical exam to check for any signs of disease, such as lumps or swelling in the neck, voice box, and lymph nodes.
- Blood hormone studies: This involves checking the levels of certain hormones released into the blood by organs and tissues in the body. Abnormal hormone levels may indicate thyroid cancer.
- Blood chemistry studies: This test measures the amounts of certain substances, such as calcium, released into the blood by organs and tissues in the body. Abnormal levels may suggest thyroid cancer.
- Surgical biopsy: During surgery, a doctor may remove either the thyroid nodule or one lobe of the thyroid to examine the cells and tissues under a microscope. This helps to check for signs of cancer.
- Calcitonin blood test: This test specifically checks for medullary thyroid cancer, which is a different type of thyroid cancer than PTC.
- Laryngoscopy: This procedure involves looking inside the throat using a mirror or a flexible tube called a laryngoscope placed through the mouth. It helps assess vocal cord function.
- Thyroid biopsy: A biopsy involves removing samples of suspicious tissue using a needle. These samples are sent to a laboratory where a pathologist examines them under a microscope to look for cancer cells.
- Thyroid scan: This scan uses radioactive iodine or a radioactive substance to create images of the thyroid gland. It helps determine if there are any areas of abnormal activity that may indicate cancer.
- TSH and free T4 blood tests: These blood tests measure thyroid function by checking hormone levels. Abnormal levels may suggest thyroid cancer.
- Ultrasound of the thyroid and lymph nodes: An ultrasound uses sound waves to create images of the thyroid gland and nearby lymph nodes. It helps identify any abnormalities that may be indicative of PTC.
- CT scan of the neck: A CT scan provides detailed pictures of areas inside the body, such as the neck, taken from different angles. It helps determine the extent or stage of PTC.
- PET scan: A PET scan uses a radioactive substance injected into the body to create images that show how organs and tissues are functioning. It can help identify areas with increased metabolic activity, which may indicate cancer spread.
- CT scan (CAT scan): This procedure provides detailed pictures of areas inside the body like the chest, abdomen, and brain from different angles. It helps determine the stage based on tumor size and spread to nearby tissues and lymph nodes.
These examinations, tests, and procedures help confirm a diagnosis of PTC by detecting abnormalities in hormone levels, identifying suspicious tissue or nodules in the thyroid gland, assessing vocal cord function, and determining if there is any spread to nearby lymph nodes or other parts of the body.
Various specialists may be involved in diagnosing PTC, including:
- Endocrinologists (doctors who specialize in hormone-related disorders)
- Otolaryngologists (ear, nose, and throat specialists)
- Radiologists (doctors who interpret imaging tests)
- Pathologists (doctors who examine tissue samples)
- Surgeons (who perform biopsies or surgeries)
These examinations help identify factors or indicators such as tumor size, spread to nearby tissues or lymph nodes (staging), which can help determine appropriate treatment options for papillary thyroid cancer.